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General NPI Number Information
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NPI Number | 1164500773
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Entity Type | Individual
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Provider Name | TOAN HUNG TRAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 10/14/2016
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Provider Practice Location Address
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Address Line | 4545 GEORGETOWN PL C16
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City | STOCKTON
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State | CA
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Zip | 95207-6215
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Country | US
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Telephone | 209-957-0641
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Fax |
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Provider Business Mailing Address
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Address Line | 4545 GEORGETOWN PL STE C16
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City | STOCKTON
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State | CA
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Zip | 95207-6230
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Country | US
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Telephone | 209-957-0641
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Fax | 209-957-0550
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | A37620
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License Number State | CA
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